What is endometriosis?

Endometriosis is a chronic medical condition in which tissue, similar to the tissue that lines the uterus (called endometrium) grows outside of the uterus, primarily in the pelvic region. This tissue can grow on ovaries, fallopian tubes, the bladder, bowel, and other structures of the body that lie within or near the pelvis. One of the primary symptoms of endometriosis is chronic pelvic pain, which is a result of inflammation from the tissue growths that can eventually lead to internal scarring and adhesions.

An exact cause of endometriosis has not been discovered. However, researchers believe that it may be related to genetic factors, immune system deficits, and hormonal imbalances. Many theories for the cause of endometriosis have been suggested, but none fully encompass the wide range of clinical manifestations associated with the condition. One widely plausible theory is that endometriosis is caused by retrograde menstruation, a common phenomenon in which some of the tissue shed during menstruation flows backwards through the fallopian tubes into the abdominal space where the stomach, intestines, and liver are contained.

Symptoms

Endometriosis can result in a variety of symptoms including:

• Chronic pelvic pain
• Heavy menstrual bleeding
• Bleeding or spotting between periods
• Painful periods
• Painful bowel movements
• Digestive problems
• Deep pelvic pain during or after sexual intercourse
• Infertility

Pelvic pain associated with endometriosis is commonly characterized as chronic, cyclic, and progressive, with periods of exacerbation. The severity of these symptoms can vary from person to person. It is also important to note that some people with endometriosis may not experience any symptoms at all.

Prevalence and diagnosis

Endometriosis is estimated to affect up to 10% of women between the ages of 15 and 44 worldwide. Women are most commonly affected in their 30s and 40s, but endometriosis can occur in women of any age who menstruate. Furthermore, the condition is most commonly diagnosed in women who have a family history of the condition and/or who have never given birth.

In order to definitively diagnose someone with endometriosis, a surgical examination must be performed. For this reason, the exact prevalence of endometriosis is hard to define, as it is often underdiagnosed. It can take an average of 4-11 years for a proper diagnosis to be made, since a wide range of symptoms can overlap with other gastrointestinal or gynecological conditions, such as pelvic inflammatory disease (PID) or irritable bowel syndrome (IBS). Some of the symptoms, like pelvic pain and heavy menstrual bleeding, can also be considered a normal physiological response to menstruation, further contributing to this diagnosis challenge.

Impact on quality of life

The physical symptoms of endometriosis, which can be quite debilitating, are only half the battle for those suffering from this condition. Many individuals with endometriosis also deal with high stress levels, fatigue, depression, and poor quality of sleep. The negative impact of endometriosis on an individual’s quality of life can be attributed to many factors including pain, reduced physical and sexual activity, infertility, and frustration due to missed or delayed diagnosis.

Furthermore, endometriosis, along with many pelvic health conditions, is highly stigmatized due to menstrual taboos, gender bias, lack of awareness, and its impact on fertility. The stigma associated with endometriosis can be rather harmful for people with the condition, as it can prevent them from seeking help, accessing appropriate treatment, and advocating for themselves. It is important to raise awareness by educating the public and healthcare providers about endometriosis to ultimately combat the stigma and empower individuals suffering from this condition to seek the treatment they need.

Care options

While there is unfortunately no cure, the symptoms associated with endometriosis are addressable. Care options include pain management, hormonal therapies, and surgery to remove the adhesions, lesions, and cysts formed by the tissue growth. Oftentimes, a combination of these options are required to treat the wide range of symptoms associated with this condition.

How Bloom can help

Bloom offers virtual pelvic health care, including pain management, for individuals suffering from endometriosis. As previously stated, the primary symptom of endometriosis is pain. Typically, people who present with any type of chronic pelvic pain tend to hold a lot of tension in their pelvic floor, abdominal, low back, and hip muscles. Over time, these muscles become tight and stiff, further contributing to the pain cycle, particularly during activities like using the bathroom and sexual intercourse. Chronic pelvic pain may also benefit from pain science and behavioral therapies as an essential component in holistic care.

Bloom helps individuals with endometriosis manage their pain and associated symptoms by teaching them how to relax and lengthen their pelvic floor muscles through a customized exercise program, designed by a Pelvic Health Specialist, all of whom have Doctor of Physical Therapy degrees. During the exercise sessions, members use the Bloom Pod by Elvie—an intravaginal device that connects to a mobile app and is used to exercise, track, and measure pelvic floor muscle movement and force, while in isolation or with abdominal, low back, and hip muscles, to provide real-time feedback and results.

Bloom also provides access to Academy, part of the Sword Health App, that has content educating members on pain science, and gives actionable tips for managing chronic pain. If surgery is part of the overall treatment plan, Bloom may even help augment surgical outcomes, pre- and post-operatively, by providing education on scar management, core activation and strength, and muscle flexibility. Lastly, it is common for the endometrial tissue to affect and surround the urinary and intestinal system, often causing painful pees, frequent urinary urges, bloating, or constipation. Bloom provides education on how to optimize bladder and bowel health with instruction on digestive massage techniques, dietary considerations, and healthy bladder and bowel habits.

Bloom is available through employers and health plans. Give your members and employees the care they deserve. Learn more at swordhealth.com/solutions/bloom.

While we use the word "women" in some of our communications, Bloom is designed for all individuals with vaginal anatomy regardless of gender identity.

Disclaimer: This article is intended for educational purposes only, using publicly available information. It is not medical advice nor should it be used for the diagnosis, treatment, or prevention of disease. Please seek the advice of your physician or another licensed medical provider for any health questions or concerns. In case of emergency, call 911.